Identification by HLA typing of intrauterine-derived maternal T cells in four patients with severe combined immunodeficiency
Histocompatibility Antigens Class II
Immunologic Deficiency Syndromes
After the initial observation of engraftment of nonfunctional intrauterine-derived maternal T cells in a patient with severe combined immunodeficiency without graft-versus-host disease, we prospectively examined all new patients with severe combined immunodeficiency for the presence of such engrafted cells in order to determine the incidence of this phenomenon. Peripheral lymphocytes were separated into E-rosette-positive and E-rosette-negative populations and then typed separately for HLA, HLA-DR antigens and other lymphocyte markers on both the E-rosette-positive and negative cells were also determined. Of 16 patients examined, four were determined to have E-rosette-positive maternal lymphocytes. The engrafted cells were functionally inactive during in vitro tests of cell-mediated immune function. In repeated examinations performed when the four patients were between the ages of six and 15 months, three of the four had neither clinical nor histologic evidence of classic graft-versus-host disease. Our studies indicate that engraftment of maternal T lymphocytes occurs with considerable frequency, but that this engraftment may not lead to overt clinical graft-versus-host disease. The characteristics of these four patients are described in this report.